With nearly 150 000 cases detected annually, colorectal cancer is the second most common cause of cancer-related death in the United States.1 Over the past 2 decades, however, the annual death rate from colorectal cancer has been declining. This improvement has partially been attributed to an increase in colorectal cancer screening and surveillance nationally. Removal of polyps that have the potential for future malignant transformation and the detection of colorectal cancer at an earlier, more curable stage have contributed to the reduction of colorectal cancer deaths.2 While colonoscopy remains the gold standard for detection of colorectal pathology, alternative modalities used for screening, including flexible sigmoidoscopy, double-contrast barium enema, and computed tomographic (CT) colonography, are acceptable choices for average-risk patients.3
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